A Clinical Study of the Flexor Tendon Injures in the Hand

Kim, Kwang Hoe; Chung, Hyun Kee; Lee, Kwang Suk; Yoon, Won Koo

Abstract

Many injuries of the hand have been occured in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Because of these efforts, the designation of Zone II as"no man's land" is no longer significant and should be called "skilled man's land". With regard to to secondary reconstructive surgery, in cases without much scarring and few associated lesions, we routinely select the one-stage graft and use early motion in the postoperative programs. This paper aimed to review our experience with 215 patients with flexor tendon injuries in hand who were treated with primary repair or tendon graft with average follow up of 8.5 months from June, 1973 to May, 1987 and the following results were obtained. 1. The most frequent site of injury was Zone V. 2. The over all end result of primary repair was satisfactory in 86.5% by White and Kleinert criteria. 3. The over all end result of tendon graft in Zone Il was satisfactory in 51.0% by White and Kleinert criteria. 4. In Zone lI, primary repair obtained satisfactory result in 36.4% but the tendon graft obtained satisfactory result in 51.0%. 5. In tendon graft, the preoperative stste was supposed to have close relation to postoperative result and the duration from injury to graft was supposed to have little relation to postoperative results. 6. In primary repair, the cases using Bunnells suture technique obtained satisfactory result in 85.1% and the cases using modified Kesslers suture technique obtained satisfactory result in 91.2%.